Medical Coding Revenue Calculator

Expected reimbursement from CPT codes and fee schedule.

Total visits per month

% Level 3 (99213)

% Level 4 (99214)

% Level 5 (99215)

% Other CPT codes

Avg other CPT reimbursement ($)

Commercial payer multiplier

Commercial payer mix (%)

Coding accuracy (%)

Tab to move between fields

Monthly expected revenue

$59,576.00

≈ 5 years of state college

Annual expected revenue

$714,917.00

≈ 17 Teslas

Avg revenue per visit$148.94

Annual wRVUs generated8,856

Coding improvement opportunity$6,821.00

Blended rate: Level 3$104.88

Blended rate: Level 4$153.90

Blended rate: Level 5$224.58

Adj Other0.05

How to Use This Calculator

Enter Total visits per month and distribute the E&M visit mix across % Level 3 (99213), % Level 4 (99214), and % Level 5 (99215).
Set % Other CPT codes and Avg other CPT reimbursement for procedures, injections, or ancillary services.
Enter Commercial payer multiplier (typically 1.2–1.8×) and Commercial payer mix (%) to blend Medicare and commercial rates.
Set Coding accuracy (%) — at 85% accuracy, the Coding improvement opportunity output shows recoverable revenue.
Review Monthly expected revenue and Annual expected revenue as your baseline projection for budgeting.
Use Annual wRVUs generated to compare provider productivity against MGMA specialty benchmarks.

How the result changes with Total visits per month

Total visits per month: Total patient encounters per month across all providers.
% Level 3 (99213): Percentage of E&M visits coded at Level 3 (low complexity).
% Level 4 (99214): Percentage of E&M visits coded at Level 4 (moderate complexity).
% Level 5 (99215): Percentage of E&M visits coded at Level 5 (high complexity).
% Other CPT codes: Percentage of visits with procedures, injections, or non-E&M codes.
Avg other CPT reimbursement ($): Average Medicare reimbursement for non-E&M CPT codes.
Commercial payer multiplier: Commercial reimbursement as a multiple of Medicare (typically 1.2-1.8x).
Commercial payer mix (%): Percentage of patients with commercial insurance.
Coding accuracy (%): Percentage of visits coded at the correct E&M level.

Monthly expected revenue: Total blended reimbursement per month.
Annual expected revenue: Projected annual reimbursement.
Avg revenue per visit: Blended average collection per encounter.
Annual wRVUs generated: Total work RVUs from the visit mix.
Coding improvement opportunity: Estimated annual revenue gained by improving coding accuracy to 100%.
Blended rate: Level 3: Payer-mix weighted reimbursement for 99213.
Blended rate: Level 4: Payer-mix weighted reimbursement for 99214.
Blended rate: Level 5: Payer-mix weighted reimbursement for 99215.

Identify Input Parameters
4 parameters
Total visits per month = 400, % Level 3 (99213) = 30, % Level 4 (99214) = 50, % Level 5 (99215) = 15 = 9 input(s) provided
Calculate Monthly expected revenue
Monthly expected revenue = visitsL3 * blendedL3 + visitsL4 * blendedL4 +
59576 = $59,576
Calculate Annual expected revenue
Annual expected revenue = monthlyRevenue * 12
714917 = $714,917
Calculate Avg revenue per visit
Avg revenue per visit = monthlyRevenue / max(1, totalVisitsPerMonth)
148.94 = $148.94
Calculate Annual wRVUs generated
Annual wRVUs generated = totalWRVUs * 12
8856 = 8856